Peacock, Kathleen Jo

Peacock, Kathleen Jo is an individual health care provider with primary practice located at 7301 Garland Ave , Takoma Park MD 20912-6417. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Peacock, Kathleen Jo can be contacted via phone (301) 807-5605.

Contact Information

Primary practice address
7301 Garland Ave Takoma Park MD 20912-6417
Phone: (301) 807-5605
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X R186240 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X RN1034066 District of Columbia

Profile Details

NPI number 1518294800
LBN Legal business name Peacock, Kathleen Jo
Credentials CNM, RN
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2009
Last updated Mar 7th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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